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| EDITORIAL |
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| Year : 2023 | Volume
: 34
| Issue : 2 | Page : 53-54 |
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Editorial
Shih-Chieh Jeff Chueh
Department of Urology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| Date of Submission | 23-May-2023 |
| Date of Acceptance | 25-May-2023 |
| Date of Web Publication | 17-Jun-2023 |
Correspondence Address:
Shih-Chieh Jeff Chueh
No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei 100225
Taiwan
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/UROS.UROS_49_23
How to cite this article:
Chueh SCJ. Editorial. Urol Sci 2023;34:53-4 |
This issue of Urological Science comprises eight articles, including a review article and seven original articles, covering a broad spectrum of urological practice, such as male lower urinary tract symptoms (LUTS), oncological and pediatric urology, stone surgery, recurrent urinary tract infections (rUTI), and even an in vitro laboratory study.
A mini review by Chiu et al. from Kaohsiung Medical University on male medical and surgical LUTS management focused on recent outcomes of minimally invasive surgical techniques ranging from classical transurethral resection of the prostate to Aquablation, prostate urethral lifting, water vapor thermal therapy (resum), i-temporary implantable nitinol device/nitinol butterfly-like stent, and even prostate artery embolization. They discussed the effectiveness and possible adverse events of the “new kids on the block,” and urologists in Taiwan are hoping to have these new “gadgets” available to serve our patients, especially considering that many of these equipment had already been cleared by the US Food and Drug Administration back in 2013. This timely mini review will help urologists in Taiwan become prepared for these new tools and have good outcomes.
Patel et al. from the University of Texas at Houston and Dallas presented an original article on the association between rUTI and bacterial motility in 139 women. They found that a higher stage of chronic cystitis under diagnostic cystoscopy was associated with a higher number of motile organisms and an increase in the presence of non-Escherichia coli motile organisms, such as Proteus, Pseudomonas, Enterobacter, and Citrobacter. The results of this study provide further evidence regarding the association between rUTI and more virulent and motile bacteria.
Reddy et al. from Manipal, India, and Southampton, UK, reported on a technique involving self-removing antegrade-tethered ureteric stents after tubeless percutaneous nephrolithotomy (PCNL) in the COVID-19 era. Based on their prospective study on 30 patients admitted to a University Teaching Hospital, shortening the recovery after PCNL is quite feasible.
With the higher incidence of upper tract urothelial carcinoma in Taiwan, Chen et al. from E-Da Hospital reported on their experience with using nephron sparing segmental ureterectomy (SU versus radical nephroureterectomy) for urothelial carcinoma of the ureter. Interestingly, they noticed that SU may preserve renal function. Although both groups had comparable overall survival and cancer-specific survival, the SU group had a shorter disease-free survival. They concluded that SU may be considered for patients with urothelial carcinoma (UC) of the ureter when preservation of renal function is warranted.
Given that intuitive is phasing out their da Vinci Si platform and asking hospitals to replace it with their da Vinci Xi platform, Chen et al. from National Taiwan University Hospital took this opportunity to examine the performance of these two platforms in terms of achieving trifecta and pentafecta outcomes after robotic-assisted partial nephrectomy. They determined that the Xi group achieved significantly higher rates of trifecta and pentafecta outcomes than did in the Si group. The use of the Xi platform was also significantly associated with low operative times and acceptable complication rates. Overall, their results support the migration from the Si to the Xi platform and the decision to phase out future production of Si parts.
Nowadays, more and more prostate biopsies are guided by the magnetic resonance fusion technique, especially for PI-RADS 4 or 5 lesions. However, with the equivocal reports on PI-RADS 3, Chiu et al. from National Taiwan University Hospital used the prostate health index (PHI) to guide decision-making for prostate biopsy in patients with gray zone multiparametric magnetic resonance imaging (MRI) lesions. They even proposed a biopsy strategy incorporating PHI and MRI, which resulted in 35% of the patients avoiding biopsies.
The study by Wong et al. from National Taiwan University Hospital and Cardinal Tien Medical Center validated the utility of the ureteral diameter ratio (UDR) for predicting vesicoureteral reflux (VUR) outcomes and determined the cutoff value for spontaneous resolution. Notably, they found that the UDR was superior to the VUR grade for predicting spontaneous VUR resolution. Moreover, they determined that a cutoff value of 0.264 may assist with clinical assessment and future management. Their findings carry significant prognostic value for children with primary VUR.
With some evidence suggesting that hyperthermia (HT) bladder instillation of cytotoxic medication might be more effective than bladder instillation of cytotoxic medication under room temperature, Chang et al. from Shin Kong Wu HoSu Memorial Hospital performed an in vitro cellular culture study, which showed that HT coadministered with various concentrations of doxorubicin significantly inhibited the viability and survival of bladder cancer cells. Moreover, HT combined with doxorubicin promoted mitochondrial apoptosis, which caused Bax upregulation and Bcl2 downregulation. The levels of cleaved caspase3 and poly (ADP-ribose) polymerase (PARP) protein expression were also elevated after cotreatment. In addition, they found that HT combined with chemotherapy further activated mitochondrial apoptosis in bladder cancer cells. They concluded that HT improved the chemosensitivity of blood cancer cells to doxorubicin. Overall, their findings suggest that HT may serve as a potential adjunctive treatment for BC that is ready for clinical application.
We hope that you find these articles interesting and relevant in expanding your urological knowledge and improving patient care.
Data availability statement
Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.
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